Abstract：
OBJECTIVE: Thyroid cancer is one of a set of extrahepatic cancers that closely linked to metabolic dysfunction-associated fatty liver disease (MAFLD). However, the connection between MAFLD and the characteristics of papillary thyroid cancer (PTC) remains unexplored.
METHODS: Between Jan 2020 and Oct 2022, surgical cases of PTC patients were examined at the first Affiliated Hospital of Wenzhou Medical University. Clinical data extracted from the electronic medical system underwent a rigorous comparison between two groups, classified based on MAFLD criteria, using logistic regression analysis.
RESULTS: In this study of 4,410 PTC patients, 18.3% had MAFLD. MAFLD emerged as a distinct risk factor for lymph node metastasis (OR = 1.230, 95% CI 1.018-1.487) in this cohort, especially in females (OR = 1.321, 95% CI 1.026-1.702) and those with BMI ≥ 23 kg/m2 (OR = 1.232, 95% CI 1.004-1.511). The presence of MAFLD was found to significantly elevate the risk of BRAF V600E mutation in both subgroups characterized by FIB-4 score ≥ 1.3 (OR = 1.968, 95% CI 1.107-3.496) and BMI < 23 kg/m2 (OR = 2.584, 95% CI 1.012-6.601). Moreover, among the subset of individuals without non-alcoholic fatty liver disease (NAFLD), it was noted that MAFLD considerably increased the likelihood of tumor multifocality (OR = 1.697, 95% CI 1.111-2.592). Nevertheless, MAFLD did not exhibit any correlation with increased tumor size, extra-thyroidal extension (ETE), or later TNM stage in PTC.
CONCLUSIONS: In this cross-sectional study, we discovered a significant association between MAFLD and increased occurrences of lymph node metastasis. Furthermore, MAFLD was linked to a higher chance of BRAF V600E mutation and the presence of multiple tumors in certain subgroups.
METHODS: Between Jan 2020 and Oct 2022, surgical cases of PTC patients were examined at the first Affiliated Hospital of Wenzhou Medical University. Clinical data extracted from the electronic medical system underwent a rigorous comparison between two groups, classified based on MAFLD criteria, using logistic regression analysis.
RESULTS: In this study of 4,410 PTC patients, 18.3% had MAFLD. MAFLD emerged as a distinct risk factor for lymph node metastasis (OR = 1.230, 95% CI 1.018-1.487) in this cohort, especially in females (OR = 1.321, 95% CI 1.026-1.702) and those with BMI ≥ 23 kg/m2 (OR = 1.232, 95% CI 1.004-1.511). The presence of MAFLD was found to significantly elevate the risk of BRAF V600E mutation in both subgroups characterized by FIB-4 score ≥ 1.3 (OR = 1.968, 95% CI 1.107-3.496) and BMI < 23 kg/m2 (OR = 2.584, 95% CI 1.012-6.601). Moreover, among the subset of individuals without non-alcoholic fatty liver disease (NAFLD), it was noted that MAFLD considerably increased the likelihood of tumor multifocality (OR = 1.697, 95% CI 1.111-2.592). Nevertheless, MAFLD did not exhibit any correlation with increased tumor size, extra-thyroidal extension (ETE), or later TNM stage in PTC.
CONCLUSIONS: In this cross-sectional study, we discovered a significant association between MAFLD and increased occurrences of lymph node metastasis. Furthermore, MAFLD was linked to a higher chance of BRAF V600E mutation and the presence of multiple tumors in certain subgroups.
摘要：
目的：甲状腺癌是一组与代谢功能障碍相关的脂肪肝（MAFLD）密切相关的肝外癌症之一。然而,MAFLD与甲状腺乳头状癌（PTC）特征之间的联系仍未被研究。
方法：在2020年1月至2022年10月期间，在温州医科大学附属第一医院检查了PTC患者的手术病例。从电子医疗系统中提取的临床数据在两组之间进行了严格的比较，根据MAFLD标准分类，采用Logistic回归分析。
结果：在这项对4,410名PTC患者的研究中，18.3%患有MAFLD。在该队列中，MAFLD是淋巴结转移的明显危险因素（OR=1.230，95％CI1.018-1.487），尤其是女性(OR=1.321,95%CI1.026-1.702)和BMI≥23kg/m2(OR=1.232,95%CI1.004-1.511)。在FIB-4评分≥1.3(OR=1.968,95%CI1.107-3.496)和BMI<23kg/m2(OR=2.584,95%CI1.012-6.601)的两个亚组中,MAFLD的存在显著增加BRAFV600E突变的风险。此外，在没有非酒精性脂肪性肝病（NAFLD）的人群中，有人指出，MAFLD大大增加了肿瘤多灶性的可能性（OR=1.697，95％CI1.111-2.592）。然而，MAFLD与肿瘤大小增加没有任何相关性，甲状腺外延伸（ETE），或PTC的TNM后期阶段。
结论：在这项横断面研究中，我们发现MAFLD与淋巴结转移发生率增加之间存在显著关联.此外，MAFLD与BRAFV600E突变的较高机会和某些亚组中多个肿瘤的存在有关。
方法：在2020年1月至2022年10月期间，在温州医科大学附属第一医院检查了PTC患者的手术病例。从电子医疗系统中提取的临床数据在两组之间进行了严格的比较，根据MAFLD标准分类，采用Logistic回归分析。
结果：在这项对4,410名PTC患者的研究中，18.3%患有MAFLD。在该队列中，MAFLD是淋巴结转移的明显危险因素（OR=1.230，95％CI1.018-1.487），尤其是女性(OR=1.321,95%CI1.026-1.702)和BMI≥23kg/m2(OR=1.232,95%CI1.004-1.511)。在FIB-4评分≥1.3(OR=1.968,95%CI1.107-3.496)和BMI<23kg/m2(OR=2.584,95%CI1.012-6.601)的两个亚组中,MAFLD的存在显著增加BRAFV600E突变的风险。此外，在没有非酒精性脂肪性肝病（NAFLD）的人群中，有人指出，MAFLD大大增加了肿瘤多灶性的可能性（OR=1.697，95％CI1.111-2.592）。然而，MAFLD与肿瘤大小增加没有任何相关性，甲状腺外延伸（ETE），或PTC的TNM后期阶段。
结论：在这项横断面研究中，我们发现MAFLD与淋巴结转移发生率增加之间存在显著关联.此外，MAFLD与BRAFV600E突变的较高机会和某些亚组中多个肿瘤的存在有关。
